Relationship of health-related social needs and hospital readmissions in patients following a hospitalization for atrial fibrillation.

Atrial fibrillation (AF) has a high economic burden on the healthcare system with rehospitalizations as the most significant contributing factor necessitating an understanding of aspects related to hospitalizations to minimize economic costs and improve patient outcomes. Our study aims to assess whether all-cause 30-day hospital readmission following AF-specific hospitalization is associated with health-related social needs (HRSN) using the Nationwide Readmissions Database (NRD). All hospitalization data were abstracted from the 2015-2019 NRD, including hospitalizations for patients at least 18 years of age with a primary discharge diagnosis of AF.

Outcomes of Prediabetes Compared with Normoglycaemia and Diabetes Mellitus in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.

: Patients with prediabetes are at increased risk of coronary artery disease (CAD). However, the association between prediabetes and adverse clinical outcomes following percutaneous coronary intervention (PCI) is inconsistent, in contrast to outcomes in patients with diabetes mellitus (DM). Thus, this meta-analysis evaluated the impact of dysglycaemia on PCI outcomes.

Catheter ablation of atrial fibrillation in hypertrophic cardiomyopathy: A proportional meta-analysis and systematic review of single-arm studies.

Background: Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic cardiomyopathy (HCM). Limited data exists about the efficacy and clinical outcomes of AF ablation in HCM.

Objective: The purpose of this meta-analysis was to evaluate the role of catheter-based ablation for treatment of AF in patients with HCM.

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American College of Cardiology Conference.

Purpose Of Review: To summarize selected late-breaking science on cardiovascular (CV) disease prevention presented at the 2023 American College of Cardiology (ACC) conference.

Recent Findings: The CLEAR outcomes randomized control trial (RCT) compared bempedoic acid to placebo in patients at high-risk of cardiovascular disease (CVD) or prevalent CVD and statin intolerance for CV outcomes. The YELLOW III was a single-arm study that evaluated the effect of Evolocumab on coronary plaque characteristics in patients with stable coronary artery disease (CAD).

Coronary Artery Aneurysms as a Cause of Acute Coronary Syndrome Presentation - A Focused Review.

Coronary artery aneurysms (CAA) are defined as a dilation of a coronary vessel greater than 1.5 times the diameter of a local reference vessel. While CAAs tend to be incidental findings on imaging, they result in complications, such as thrombosis, embolization, ischemia, arrhythmias, and heart failure.

Comparison of Transfemoral versus Transsubclavian/Transaxillary access for transcatheter aortic valve replacement: A systematic review and meta-analysis.

Femoral access is the gold standard for transcatheter aortic valve replacement (TAVR). Safe alternative access, that represents about 15 % of TAVR cases, remains important for patients without adequate transfemoral access. We aimed to perform a systematic review and -analysis of studies comparing transfemoral (TF) access versus transsubclavian or transaxillary (TSc/TAx) access in patients undergoing TAVR.

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2022 European Society of Cardiology Congress.

Purpose Of Review: Focused review of select studies presented at the 2022 European Society of Cardiology Congress.

Recent Findings: Included studies assessed the effects of aspirin and omega-3 fatty acid supplements on heart failure (ASCEND study); the impact of icosapent ethyl on ST-elevation MI incidence (REDUCE-IT); air temperature's effect on cardiovascular mortality (EXHAUSTION project); LVEF outcomes after troponin-guided neurohormonal blockade for the prevention of anthracycline toxicity; efficacy of routine stress testing after high-risk PCI (POST-PCI trial); influenza vaccine among patients with acute coronary syndromes (VIP-ACS trial); empagliflozin in patients with acute myocardial infarction (EMMY); effects of comprehensive imaging-based cardiovascular screening on death and cardiovascular events (DANCANVAS); safety of long-term evolocumab in patients with established atherosclerotic cardiovascular disease (FOURIER-OLE); and use of a cardiovascular polypill as a global strategy to improve secondary prevention (SECURE). Research presented at the 2022 ESC Congress highlighted many novel applications of preventative and treatment strategies in cardiology, including the effects of environmental risk factors on the incidence of cardiovascular disease.

A new dawn in internal medicine education curriculum-a project by the residents, with the residents, for the residents.

The academic half-day (AHD) curriculum is an alternative to the noon conference (NC) approach. To date, there is little literature evaluating the transition from NC to AHD in internal medicine residency programs. We investigated the effectiveness of AHD by comparing in-training exam (ITE) and American Board of Internal Medicine (ABIM) certifying exam scores of residents before and after implementation of AHD.

Prevalence of Post-Heart Transplant Malignancies: A Systematic Review and Meta-Analysis.

The prevalence of different cancers after heart transplant (HT) is unclear due to small and conflicting prior studies. Herein, we report a systematic review and meta-analysis to highlight the prevalence and pattern of malignancies post-HT. We conducted an extensive literature search on PubMed, Scopus, Cochrane databases for prospective or retrospective studies reporting malignancies after HT.

Implementation of Multiple Evidence-Based Heart Failure Therapies.

Despite the advancements in the management of heart failure, acute heart failure is one of the most common causes of mortality and morbidity. In light of the financial burden imposed by heart failure hospitalizations on the health care system, this area remains the focus of research, clinical advances, and policy changes aimed at improving the quality of care and outcomes. Despite practice guidelines, high-quality trial data, and consensus statements, barriers to therapy remain.

Shockwave lithotripsy for treatment of calcific renal artery stenosis after an inadequately expanded renal artery stent.

Renal artery calcifications can be associated with insufficient stent expansion and in-stent restenosis. Intravascular lithotripsy (IVL) uses shockwaves to disrupt calcium and treat calcific renal in-stent restenosis. Herein, the authors present a case to treat resistant reno-vascular hypertension and in-stent restenosis of an inadequately expanded renal stent in a patient with severe calcific renal artery stenosis.

Trends, outcomes, and management of acute myocardial infarction in patients with chronic viral hepatitis.

Objectives: There is a paucity of data on the management and outcomes of chronic viral hepatitis (CVH) patients [including chronic hepatitis B (CHB) and chronic hepatitis C (CHC)] presenting with acute myocardial infarction (AMI).

Methods: We utilized the National Inpatient Sample database (2001-2019) and studied the management and outcomes of CVH patients with AMI and stratified them by subtypes of CVH. The adjusted odds ratio (aOR) of adverse outcomes in CVH groups were compared to no-CVH groups using multivariable logistic regression.

Transradial versus transfemoral approach for percutaneous coronary intervention in patients with ST-elevation myocardial infarction complicated by cardiogenic shock: a systematic review and meta-analysis.

Background: In ST-elevation myocardial infarction (STEMI), transradial access (TRA) for percutaneous coronary intervention (PCI) is associated with less bleeding and mortality than transfemoral access (TFA). However, patients in cardiogenic shock (CS) are more often treated via TFA. The aim of this meta-analysis is to compare the safety and efficacy of TRA vs.

Subcutaneous gluteal abscess from in an immunocompetent adult.

Fungal infections have been drastically increasing in incidence in recent years, preferentially affecting immunocompromised hosts and causing potentially fatal outcomes. One of the emerging fatal fungal pathogens is , a non-Candida yeast that has been increasingly reported in recent years. Previous literature has described as primarily affecting immunocompromised hosts, specifically those who are neutropenic, and causing fatal disseminated infections.

Sex Differences in the Clinical Outcomes After Left Atrial Appendage Closure: A Systematic Review and Meta-Analysis.

Introduction: Left atrial appendage occlusion (LAAO) has emerged as a reasonable alternative to oral anticoagulation in a selective group of patients with atrial fibrillation (AF). While women are known to have higher risk of AF-related stroke, the impact of sex differences on the clinical outcomes of LAAO has not been well-studied.

Objective: We sought to perform a meta-analysis evaluating sex differences on the outcomes of patients undergoing LAAO.

Timing of Coronary Angiography in Patients Following Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation: A Systematic Review and Meta-Analysis of Randomized Trials.

Introduction: Out-of-hospital cardiac arrest (OHCA) has a poor prognosis. The timing and role of early coronary angiography (CAG) in OHCA patients without ST elevation remains unclear.

Objective: We performed a meta-analysis of randomized controlled trials (RCTs) that compared early CAG to delayed CAG in OHCA patients without ST elevation.

Is Methamphetamine-Linked Cardiomyopathy an Emerging Epidemic for New Generation?

The use of methamphetamines is growing worldwide with cardiovascular disease as the leading cause of mortality and morbidity. Long-term use of methamphetamines is associated with malignant hypertension, myocardial ischemia, pulmonary hypertension, and methamphetamines-associated cardiomyopathy. These effects are noted to be dose-dependent and potentially reversible with discontinuation of methamphetamines in the early stages when there is limited or no myocardial fibrosis.

Impact of sex on outcomes of percutaneous coronary intervention for chronic total occlusion: A meta-analysis.

Background: Women are underrepresented in chronic total occlusion (CTO) trials and little is known about sex differences in the outcomes of CTO percutaneous coronary intervention (PCI). This meta-analysis aims to compare the outcomes of CTO PCI in males and females.

Methods: A comprehensive search of PubMed, EMBASE, Cochrane, Web of Science, and Google Scholar was performed for studies comparing outcomes of CTO PCI in females versus males from inception to January 26, 2021.

Meta-Analysis of Transradial Versus Transfemoral Access for Percutaneous Coronary Intervention in Patients With Chronic Kidney Disease.

Data comparing outcomes of transradial (TR) versus transfemoral (TF) access for percutaneous coronary intervention (PCI) in chronic kidney disease (CKD) including patients with eGFR< 30 ml/min/1.73m and patients with end-stage renal disease on dialysis (ESRD) are lacking. This meta-analysis compares the outcomes of TR versus TF approach for PCI in patients with CKD.

Impact of Diabetes Mellitus on Outcomes of Percutaneous Coronary Intervention in Chronic Total Occlusions: A Systematic Review and Meta-Analysis.

Background: Patients with diabetes mellitus (DM) have a high prevalence of coronary chronic total occlusions (CTOs). We conducted a systematic review and meta-analysis to characterize outcomes after CTO percutaneous coronary intervention (PCI) in patients without or with DM.

Methods: PubMed, EMBASE, Cochrane, and Google Scholar were queried for studies comparing non-DM vs.

Who Will Be Responsible for the Dialysis Bill? A Case Report and Narrative Review of Insulin Affordability 100 Years After the Discovery of Insulin.

A 46-year-old woman was type 1 diabetes diagnosed at the age of 9 who had previously been on an insulin pump. Other co-morbidities included CKD IV, HTN, and hypothyroidism. She presented with hyperglycemia of 400 mg/dl and fluid retention.

Challenges in Implementing Evidence Based Cross-Disciplinary Therapies: Are Cardiovascular Specialists Ready to Claim SGLT-2 Inhibitors and GLP-1 Analogs?

Cardiovascular disease is a leading cause of morbidity, mortality and financial burden to the United States health system. A change in focus towards preventive medicine along with advances in pharmacologic and invasive therapies, has led to improved cardiac death rates. These benefits however, come with increased prevalence of heart failure and soaring readmission rates.

Lemierre's syndrome with muscle necrosis and chronic osteomyelitis.

Lemierre's syndrome is a rare disorder characterized by thrombophlebitis of the internal jugular vein and is caused by gram-negative anaerobes, primarily . We report a case of a 20-year-old man who developed chronic osteomyelitis of the femur and myonecrosis of thigh muscles secondary to this syndrome. The diagnosis was made based on clinical presentation and evidence of thrombosis in the internal jugular vein on ultrasound.